Drug-induced thrombocytopenia: clinical data on 309 cases and the effect of corticosteroid therapy |
| |
Authors: | U Pedersen-Bjergaard M Andersen P B Hansen |
| |
Institution: | (1) Department of Haematology and Internal Medicine, Herlev Hospital, University of Copenhagen, Denmark, DK;(2) Department of Internal Medicine F, Hillerod Hospital, Helsevej 2, DK-3400 Hillerod, Denmark Tel.: +45-48294812; fax +45-48294783, DK;(3) Danish Committee on Adverse Drug Reactions, National Board of Health, Denmark, DK |
| |
Abstract: | Objective: To analyse the clinical picture and the course of thrombocytopenia induced by non-cytotoxic drugs, and to evaluate a possible
therapeutic effect of corticosteroids.
Methods: A retrospective analysis of 309 well-documented cases of drug-induced thrombocytopenia was performed. Data sources were
reports from the files of the Danish Committee on Adverse Drug Reactions and discharge summaries.
Results: The median length of exposure to the offending drug, before development of thrombocytopenia, was 21 days. The median nadir
platelet count was 11 × 109 · l−1, and 74% of the patients had clinical haemorrhage. Bone marrow examination generally showed hyperplastic reactive changes
and a variable number of megakaryocytes. Slight leucopenia was present in 6% of the patients and 16% were anaemic. Complete
recovery was seen in 87% of cases, with a median recovery rate of 8 days. The standard treatment was corticosteroids, which
were administered in 53% of the cases. No difference in recovery between corticosteroid-treated and untreated patients was
observed. No other clinical parameter affected the recovery rate. The mortality rate due to haemorrhage was 3.6%.
Conclusion: Thrombocytopenia induced by non-cytotoxic drugs is characterised by a heterogeneous clinical picture and recovery is generally
rapid. Although corticosteroids seem inefficient, we still recommend that severe symptomatic cases of drug-induced thrombocytopenia
are treated as idiopathic thrombocytopenic purpura due to the difficult initial differentiation between the two conditions.
Received: 11 October 1996 / Accepted in revised form: 24 December 1996 |
| |
Keywords: | Thrombocytopenia Corticosteroids Idio‐ syncrasy blood dyscrasias adverse drug reactions |
本文献已被 SpringerLink 等数据库收录! |
|